Organization
GOLDEN STATE PHARMACY
Active
Other names
GOLDEN STATE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE E. GONZALEZ (CFO/TECH)
(209) 420-1720
Entity
Organization
Contact information
Practice address
1617 N CALIFORNIA ST STE 1F, STOCKTON, CA 95204-6117
(209) 420-1720
(209) 227-7377
Mailing address
1617 N CALIFORNIA ST STE 1F, STOCKTON, CA 95204-6117
(209) 420-1720
(209) 227-7377
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
46048
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4814941
—
CA
Enumeration date
05/30/2018
Last updated
06/07/2022
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